Healthcare leaders are often expected to compartmentalize emotion to make difficult decisions, drive results, and maintain operational focus. For many years, I led this way—fair, decisive, and outcome-oriented. Over time, however, I learned that performance and compassion are not mutually exclusive. In fact, trust, psychological safety, and empathy can strengthen execution, particularly during periods of profound change.
No healthcare leader hopes to close a hospital. Yet I was responsible for overseeing the closure of a once-respected tertiary and academic medical center in New York City. What followed were 18 months of intense opposition, legal challenges, regulatory scrutiny, misinformation, and mounting operational strain—made even more difficult by workforce shortages and evolving care models. How we navigated this period underscored the power of compassionate leadership.
By late 2023, hospital care in New York City—and nationally—had changed dramatically. As care shifted to outpatient settings and designated centers of excellence, inpatient demand declined. Our facility contracted from more than 700 beds to roughly 200 occupied beds, with most specialty services relocated elsewhere. While we established a nearby Behavioral Health Services Center of Excellence to preserve access, the remaining hospital required major capital investment and had was operating at a significant loss. With no viable funding path, aging infrastructure, and other tertiary hospitals nearby, closure became unavoidable.
The decision triggered deep emotional responses from staff, alumni, trainees, and the surrounding community. For many employees, the hospital was more than a workplace—it was a professional home. That connection fueled resistance, heightened emotion, and the spread of rumors that at times complicated already fragile trust.
Leading through this environment required one essential principle: compassion.
Compassionate leadership means acknowledging fear, grief, and uncertainty while communicating clearly and truthfully. It requires leaning into difficult conversations, explaining the “why” behind decisions, listening without defensiveness, and resisting the urge to minimize emotions. Well before and then during the closure process, senior leaders prioritized presence and connection—remaining accessible, transparent, and human. Importantly, we maintained quality and safety throughout one of the most challenging staffing environments imaginable.
Our leadership team also relied on one another. We created space to process loss, frustration, and uncertainty together—strengthening trust and alignment. That cohesion mattered. In healthcare, challenges are inevitable, but when leadership is unified and moving in the same direction, complexity becomes more manageable.
Several practical strategies proved especially effective:
1. Understanding responses to change.
With support from an executive coach, we prepared for the predictable—but deeply personal—ways individuals experience change. Recognizing that people move through these phases at different speeds helped us respond with patience rather than urgency.
2. Intentional communication.
Virtual meetings and email were useful early on but became less effective over time, as messages were shared out of context. What worked best were live Q&A sessions across all shifts and, most importantly, in-person rounding.
3. Rounding with purpose.
Consistent, unhurried rounding on all shifts became our most effective communication and trust-building tool. Leaders traveled in pairs, listened more than they spoke, addressed misinformation quickly, and checked in on staff as people—not just employees. Visibility built credibility.
4. Presence and availability.
An open-door approach—meeting individually or in groups—allowed leaders to support staff through career decisions or simply bear witness to their experience. Being present mattered as much as any operational plan.
Together, we closed the hospital, transitioned thousands of employees and faculty to new roles, and kept patients safe.
Change is inevitable in healthcare. Navigating it successfully requires more than operational rigor—it demands compassion. Leaders who build this skill before crisis strikes are better equipped to guide their organizations through even the most difficult transitions.
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